Ischemic and Hemorrhagic Stroke: Assessment, Treatment, and Rehabilitation Flashcards | Quizlet

What is an Ischemic Stroke?

An Ischemic Stroke is caused by a blockage of blood flow to the brain, either from clot formation or a blockage lodged in the brain.

What are the two types of Ischemic Stroke?

Thrombotic (clot formation with a narrow lumen) and Embolic (an embolus circulating in the blood lodges into a cerebral artery).

What percentage of strokes are ischemic strokes?

Approximately $85\%$.

What percentage of strokes are caused by atrial fibrillation (a-fib)?

$25\%$.

What are the risk factors for TIA - CVA identified in the lecture?

Smoking, hypertension, hyperlipidemia, oral contraceptive, and a-fib.

What is the Circle of Willis?

A circular network of arteries at the base of the brain that provides collateral blood flow.

Over how many hours may stroke symptoms continue to worsen?

$72\text{ hours}$.

Where do most emboli originate in an embolic stroke?

In the endocardial layer of the heart, with atrial fibrillation and plaque being the most common causes.

How soon after arrival must a stroke patient receive a plain CT scan?

Within $20\text{--}25\text{ min}$ of arrival.

Why is a plain CT used instead of a contrast CT for initial stroke evaluation?

No contrast with brain bleeds.

Within what timeframe can intravenous tPA be administered from symptom onset?

Within $3\text{--}4.5\text{ hours}$ of onset of symptoms.

Within what timeframe should tPA be administered if given via the intra-arterial route?

Within $6\text{ hours}$ of onset.

What does the acronym BE FAST stand for in stroke recognition?

B - Balance, E - Eyes, F - Face, A - Arms & Legs, S - Speech, T - Time.

What is the first priority in nursing care for a stroke patient?

The first priority is ensuring ABC (Airway, Breathing, Circulation).

What blood pressure level is recommended for a possible stroke for the first 24-48 hours?

Below $180/105\text{ mmHg}$ for $24\text{--}48\text{ hours}$.

If a patient loses eyesight following a stroke, where did the stroke occur?

Occipital region.

What is a key symptom commonly reported with a Hemorrhagic Stroke or aneurysm?

The 'worst headache of my life,' frequently accompanied by vomiting and neck pain.

What percentage of strokes are categorized as hemorrhagic strokes?

$15\%$.

What is the recommended patient position for managing care after a hemorrhagic stroke?

Keep head neutral and elevate the head of the bed (HOB) to $30\text{ degrees}$.

What surgical procedures are utilized for the treatment of an aneurysm causing hemorrhagic stroke?

Clipping or coiling.

What is the recommended blood pressure range to maintain for a patient with a hemorrhagic stroke?

Maintain between $140\text{ to }160\text{ mmHg}$.

If a patient is taking warfarin and suffers a hemorrhagic stroke, what intervention is required?

Reverse with vitamin K.

What pupil changes on a PERRLA assessment can occur if there is a hemorrhagic bleed?

Dilation and may not react to light.

Why should dentures be removed if a stroke is suspected?

Remove them because airway needs to be monitored and if they need to be intubated.

Which type of stroke carries the highest mortality rate?

Hemorrhagic stroke.